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Resilience Predicts Functional Outcomes in People Aging With Disability: A Longitudinal Investigation.

Title

Resilience Predicts Functional Outcomes in People Aging With Disability: A Longitudinal Investigation.

Publication Type

Journal Article

2015

Authors

Silverman AM, Molton IR, Alschuler KN, Ehde DM, Jensen MP

Journal

Arch Phys Med Rehabil

Date Published

2015 Mar 7

ISSN

1532-821X

OBJECTIVES: To investigate the links between resilience and depressive symptoms, social functioning, and physical functioning in people aging with disability and to investigate the effects of resilience on change in functional outcomes over time. DESIGN: Longitudinal postal survey. SETTING: Surveys were mailed to a community sample of individuals with 1 of 4 diagnoses: multiple sclerosis, muscular dystrophy, postpoliomyelitis syndrome, or spinal cord injury. The survey response rate was 91% at baseline and 86% at follow-up. PARTICIPANTS: A convenience sample of community-dwelling individuals (N=1594; age range, 20-94y) with multiple sclerosis, muscular dystrophy, postpoliomyelitis syndrome, or spinal cord injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Patient Health Questionnaire-9 (to assess depressive symptoms) and Patient Reported Outcomes Measurement Information System (to assess social role satisfaction and physical functioning). RESULTS: At baseline, resilience was negatively correlated with depressive symptoms (r=-.55) and positively correlated with social and physical functioning (r=.49 and r=.17, respectively). Controlling for baseline outcomes, greater baseline resilience predicted a decrease in depressive symptoms (partial r=-.12) and an increase in social functioning (partial r=.12) 3 years later. CONCLUSIONS: The findings are consistent with a view of resilience as a protective factor that supports optimal functioning in people aging with disability.

What is this research about?

Living with a condition like multiple sclerosis or spinal cord injury can be challenging and stressful, and can put people at risk for depression. However, many people who have these conditions still enjoy a high quality of life, are happy, and participate in their communities. We were interested in finding out why some people with chronic health conditions are happier and more involved in their communities than others. In particular, we wanted to find out whether people do better over time if they feel more resilient. Resilience describes someone’s ability to bounce back or recover after a stressful experience.

What did the researcher do?

We surveyed about 1,500 people with either muscular dystrophy, multiple sclerosis, post-polio syndrome, or spinal cord injury twice. In the first survey we asked them how resilient they felt in general, such as how well they adapt to changes or see the humorous side of problems. We also asked them about symptoms of depression (such as how often they felt sad or had trouble concentrating) and how satisfied they were with their participation in important activities, like doing household chores, working, and being part of family life. Then, three years later, we surveyed them again and asked them the same questions about their depression levels and their participation in activities, to look at changes over time.

What did the researchers find?

People who felt more resilient reported doing better on both surveys. They were less depressed and they were more satisfied with their involvement in family and community life. These patterns appeared on the second survey as well, showing that the more resilient a person was, the more their functioning improved over time. People in our sample who were more resilient were less likely to become depressed over the three years between surveys, and their community involvement increased more than those who were less resilient.

How can you use this research?

Resilience helps us cope well with stressful experiences over time. There are a few things we can do to increase our resilience:

Spend time with friends and loved ones, especially when you are stressed.

Regularly think about things and people you are grateful for.

Make time to do things you enjoy and find meaning in. This might include making art or music, gardening, reading, watching funny movies, going to religious services, or volunteering.

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